<%@ page import="com.pmsco.pms.core.constant.PmsConstant"%>
<%@ page import="com.pmsco.pms.util.BundleUtil"%>
<%@ include file="/WEB-INF/import/tagLibs.jsp" %>
<script>
    $(function() {
        $("#dob").datepicker({
        	dateFormat: '<%=BundleUtil.getInstance().getKey("date.format")%>',
        	changeMonth: true,
            changeYear: true,
            yearRange: "<%=BundleUtil.getInstance().getKey("date.yearRanges")%>",
            defaultDate: "<%=BundleUtil.getInstance().getDefaultDate()%>"
       	});
        
        $("button").button();
    });
   </script>
<table id="accountInformation">
	<input type="hidden" id="userId" name="userId" value=""/>
	<tr>
		<td class="tableFormLabel"><label class="tableFormLabelRequired">*&nbsp;</label><spring:message code="user.userName"/></td>
		<td><input type="text" class="talbeFormTextBoxReadOnly" id="userName" name="userName" size="15" readonly="readonly" required/></td>
	</tr>
	<tr>
		<td class="tableFormLabel"><label class="tableFormLabelRequired">*&nbsp;</label><spring:message code="user.lastName"/></td>
		<td><input type="text" class="talbeFormTextBox" id="lastName" name="lastName" value="" size="15" required/></td>
	</tr>
	<tr>
		<td class="tableFormLabel"><spring:message code="user.midName"/></td>
		<td><input type="text" class="talbeFormTextBox" id="midName" name="midName" value="" size="50"/></td>
	</tr>
	<tr>
		<td class="tableFormLabel"><label class="tableFormLabelRequired">*&nbsp;</label><spring:message code="user.firstName"/></td>
		<td><input type="text" class="talbeFormTextBox" id="firstName" name="firstName" value="" size="15" required/></td>
	</tr>
	<tr>
		<td class="tableFormLabel"><label class="tableFormLabelRequired">*&nbsp;</label><spring:message code="user.idNumber"/></td>
		<td><input type="text" class="talbeFormTextBox" id="idNumber" name="idNumber" value="" size="15" required/></td>
	</tr>
	<tr>
		<td class="tableFormLabel"><label class="tableFormLabelRequired">*&nbsp;</label><spring:message code="user.dob"/></td>
		<td><input type="text" class="talbeFormTextBox" id="dob" name="dob" value="" size="15" readonly="true" required/></td>
	</tr>
	<tr>
		<td class="tableFormLabel"><spring:message code="user.cellPhone"/></td>
		<td><input type="text" class="talbeFormTextBox" id="cellPhone" name="cellPhone" value="" size="15"/></td>
	</tr>
	<tr>
		<td class="tableFormLabel"><spring:message code="user.homePhone"/></td>
		<td><input type="text" class="talbeFormTextBox" id="homePhone" name="homePhone" value="" size="15"/></td>
	</tr>
	<tr>
		<td class="tableFormLabel"><label class="tableFormLabelRequired">*&nbsp;</label><spring:message code="user.homeAddr"/></td>
		<td><input type="text" class="talbeFormTextBox" id="homeAddr" name="homeAddr" value="" size="80" required/></td>
	</tr>
	<tr>
		<td class="tableFormLabel"><label class="tableFormLabelRequired">*&nbsp;</label><spring:message code="user.emailAddr"/></td>
		<td><input type="email" class="talbeFormTextBoxReadOnly" id="emailAddr" name="emailAddr" value="" size="50" readonly="readonly"/></td>
	</tr>
 	<tr>
		<td>
			<button class="tableFormButton" onclick="return submitAccountInformation();"><spring:message code="button.save"/></button>
		</td>
	</tr>
</table>
